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3 in 5 pregnancy-related deaths in US are preventable, report says

Pregnancy-related deaths can happen up to a year after birth and are preventable in the majority of cases, according to a new report. These deaths include th...

Posted: May 8, 2019 11:34 AM

Pregnancy-related deaths can happen up to a year after birth and are preventable in the majority of cases, according to a new report. These deaths include those caused by a pregnancy complication, events triggered by pregnancy or the worsening of an underlying condition due to the effects of pregnancy on the body.

Researchers at the US Centers for Disease Control and Prevention analyzed national data reported to the agency's Pregnancy Mortality Surveillance System between 2011 and 2015. They also examined detailed data from the Maternal Mortality Review Committee in 13 states gathered between 2013 and 2017.

From 2011 to 2015, there were a total of 3,410 pregnancy-related deaths in the United States, consistent with known rates of about 700 deaths per year. Nearly 31% of the deaths in the study happened during pregnancy, 36% happened the day of delivery or the week after, and 33% happened one week to one year after delivery, according to the findings, published Tuesday in the CDC's Morbidity and Mortality Weekly Report.

"We really wanted to know more about the timing of death," said the report's lead author, Dr. Emily Petersen, medical officer and ob-gyn in the CDC's Division of Reproductive Health.

"I think, a lot of times, people might think that pregnancy-related deaths occur just around delivery, but we actually also see that pregnancy-related deaths happen before, during and up to one year after delivery," she added.

Heart disease and stroke caused more than 1 in 3 -- or 34% -- of pregnancy-related deaths. Additional causes of death varied by timing.

Most deaths occurring around delivery were caused by obstetric emergencies such as severe bleeding and amniotic fluid embolism, in which the fluid enters the mother's bloodstream and causes a disturbance in the blood-clotting system. The week after delivery, severe bleeding, high blood pressure and infection were the most common causes of death. Cardiomyopathy, a weakening of the heart muscle, was the most common cause of death the year after delivery, according to the results.

The results also confirmed known racial disparities: Black women were about three times as likely to die from a pregnancy-related cause as white women.

"We also found a disparity in American Indian Alaskan native women, and that was 2.5 times as high as white women," said Nicole Davis, an epidemiologist in the Division of Reproductive Health and co-author of the study. She emphasized that continued monitoring and reporting of the disparities are key to prevention strategies.

The racial and ethnic disparities may be in part explained by structural racism, said Dr. Wanda Barfield, director of the Division of Reproductive Health in the CDC's National Center for Chronic Disease Prevention and Health Promotion. Structural racism can directly affect when women are seen, the quality of the care and advice they receive, and even how much they trust their doctors, she said.

The disparities are also likely to be worsened by variations in hospital quality, with women living in rural America sometimes delivering at hospitals not equipped to handle the complications they may face, Barfield added.

Variations in who is affected by chronic conditions with the potential to worsen during pregnancy add yet another layer, with black women experiencing higher rates of heart disease and hypertension before pregnancy, she said.

"We do want the public to know that maternal deaths are relatively rare; most pregnancies do result in a safe experience for both mom and baby," Peterson said. "But every maternal death is tragic, and we are learning that it often represents a web of missed opportunities."

By analyzing a subset of the reported deaths, the Maternal Mortality Review Committee in each of the 13 states involved in the study determined that 3 out of every 5 -- or 60% -- of the deaths were preventable, regardless of race or ethnicity.

The committees also outlined contributing factors and strategies to prevent pregnancy-related deaths, including ways to improve access to clinical care, public awareness of warning signs and accurate diagnosis by physicians.

For women and their families, the authors recommend discussing warning symptoms of complications with health care providers and clearly stating that they recently gave birth any time they receive medical care in the year after delivery.

"No single intervention is sufficient; reducing pregnancy-related deaths requires reviewing and learning from each death, improving women's health, and reducing social inequities across the life span, as well as ensuring quality care for pregnant and postpartum women," the report says.

Barfield said in a statement that "By identifying and promptly responding to warning signs not just during pregnancy, but even up to a year after delivery, we can save lives."

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 703345

Reported Deaths: 13194
CountyCasesDeaths
Marion959691716
Lake51222940
Allen38926670
Hamilton34288404
St. Joseph33770539
Elkhart27117431
Vanderburgh22034393
Tippecanoe21671212
Johnson17451374
Porter17206297
Hendricks16735310
Clark12657190
Madison12302337
Vigo12155244
Monroe11385166
LaPorte10800204
Delaware10312184
Howard9617211
Kosciusko9068113
Hancock7939139
Bartholomew7854153
Warrick7675155
Floyd7542176
Wayne6880198
Grant6773170
Boone6524100
Morgan6370138
Dubois6071117
Marshall5753108
Dearborn568075
Cass5671102
Henry5563100
Noble537983
Jackson492369
Shelby477795
Lawrence4332118
Gibson427389
Harrison426570
Montgomery416486
Clinton416053
DeKalb406684
Huntington376980
Whitley375539
Miami371465
Knox365389
Steuben362657
Putnam351960
Wabash346677
Jasper346146
Adams337652
Ripley333368
Jefferson311579
White307354
Daviess288899
Wells285180
Decatur278592
Fayette277062
Greene270385
Posey268333
Scott260553
Clay252244
LaGrange251470
Randolph234480
Washington230431
Spencer227431
Jennings224647
Fountain207745
Sullivan207342
Starke201952
Owen191856
Fulton190839
Carroll185620
Jay185529
Perry179536
Orange176553
Rush170324
Vermillion165743
Franklin165435
Tipton160943
Parke143816
Blackford132831
Pike130134
Pulaski113145
Newton102934
Brown99640
Crawford97014
Benton96213
Martin82415
Warren78915
Switzerland7698
Union69610
Ohio55511
Unassigned0405

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1048109

Reported Deaths: 18917
CountyCasesDeaths
Franklin1217031352
Cuyahoga1063982060
Hamilton779451165
Montgomery49883989
Summit45144907
Lucas39826760
Butler37638568
Stark31348894
Lorain24090472
Warren23835291
Mahoning20822583
Lake19915362
Clermont19397228
Delaware17972130
Licking16089206
Fairfield15646196
Trumbull15521459
Medina14815259
Greene14613236
Clark13576288
Wood12709184
Portage12313194
Allen11303229
Richland11017198
Miami10511212
Muskingum8688127
Wayne8543209
Columbiana8527226
Pickaway8421120
Marion8360135
Tuscarawas8359239
Erie7540153
Ross6692145
Hancock6683123
Geauga6527146
Ashtabula6458164
Scioto6280100
Belmont5591158
Union556247
Lawrence5458102
Jefferson5283147
Huron5270113
Darke5264121
Sandusky5164119
Seneca5093118
Washington5074107
Athens499454
Auglaize474884
Mercer470384
Shelby455089
Knox4371108
Madison421058
Putnam420298
Ashland412086
Fulton407966
Defiance399996
Crawford3858100
Brown385555
Logan372276
Preble369598
Clinton359659
Ottawa355478
Highland346059
Williams323274
Champaign318556
Jackson306951
Guernsey305848
Perry289349
Fayette276948
Morrow274439
Hardin263563
Henry263166
Coshocton258257
Holmes252699
Van Wert238662
Gallia233246
Pike232431
Adams227552
Wyandot226353
Hocking208958
Carroll188947
Paulding168538
Meigs141438
Noble132737
Monroe128841
Morgan106423
Harrison105336
Vinton81414
Unassigned02
Fort Wayne
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Angola
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Fort Wayne
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Lima
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Temperatures start to climb back up on Friday as we'll see mostly sunny skies return to northeast Indiana and northwest Ohio.
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